Cause of Death
by whitchry9
Summary: Sherlock can't help but feel responsible when people die because he didn't work fast enough. It's only right that he do something about it. TW for self harm. Written for a prompt. 5 chapters.
1. Chapter 1

"What was her name?" Sherlock asked quietly.

Lestrade looked up at him from the body of the young girl on the ground. "Why?"

"What was her name?" Sherlock repeated.

Lestrade frowned. "Eliana Miller."

"Can you spell that?" he asked, scratching on his notepad.

Lestrade looked confused, but obeyed without asking any more questions. The photographers were finishing up, and the coroner was moving in to zip her up in a bag and take her away.

Sherlock apologized to her silently.

_I'll make it up to you._

With that, Sherlock was done, nodding to Lestrade. The DI would let him know the results of the autopsy, which would no doubt show the stab wound as the cause of death. The interrogation would be dull, and Sherlock didn't even want to know the outcome of that.

He couldn't help but wish he'd beaten the man to death. Perhaps then he wouldn't have to do it.

_No, _he realized, he still would. _But he'd feel better._

He took a cab home, coat collar turned up.

_What if._

What if John was with him, instead of at home with his pregnant wife? What if he'd taken the tube instead of a cab to where the girl was being held? What if he went left instead of right when the hallway split? What if he'd realized the reagent he needed to determine the kidnapper's location sooner? What if Molly wasn't off sick with the flu, and she'd been the one to do the autopsies on the previous victims instead of some spotted boy Sherlock didn't know?

Would Eliana Miller still be alive?

Sherlock hated that he could never know.

He paid the cabbie without a word (didn't try to kill him, always a nice surprise) and headed up to the flat. His flat. No longer their flat.

He could hear Mrs Hudson bustling around, likely in her kitchen, but couldn't deal with her at the moment. He had things to do.

He chose the upper thigh. Right, outside. A bit tricky to get to with his right hand, but he could make do. He certainly wasn't going to do it with the left hand, he'd end up with something illegible.

And he couldn't do that to her.

Her name was relatively easy. Mostly straight lines, not many letters with curves, making it easier for him to drag the scalpel across his skin. (Gabriella Monroe was particularly hard, lots of curving, lots of tearing rather than cutting.)

It didn't take him long, and he dabbed at the area with sterile gauze. (He wasn't stupid. He knew how to avoid getting an infection.)

When the bleeding slowed, and finally stopped, he taped a fresh piece of gauze down, just to be safe. He'd bled on his pyjama pants before. Never again. He rinsed the scalpel and set it aside to be sterilized again. He lived in hopes of never needing it again, but that was far too optimistic. Sherlock was a realist.

Within a week it would be comfortably scabbed over, by the end of the second it would be pink new tissue, by the end of the month it would only be a scar. He knew from previous experience that he healed quickly. He'd done it enough times.

The first time was the hardest. He started out fine, with the craft knife he'd taken from school, held under a bunsen burner flame until the metal glowed. The first cut was shaky, and he'd lost his nerve by the end of 'Powers' so it hadn't scarred. But 'Carl' was still clearly visible on his left calf. The 'C' was wobbly, but it was the first name he'd done. By no means was it his first cut, but the first one that he'd used to make sense of things, to keep track of things he wanted to delete, and yet, remember.

Carl was the first. (He didn't fail to save Carl, not really, but he failed to reveal the truth of what happened to him. He rationalized it to himself, of course, he was only a child himself, why would anyone listen to him? But he still did it.) No more names had come for a long time after that, until he nearly overdosed, and the boy next to him did. (He wasn't sure why, or how, but he felt responsible for it.)

Then after he got clean and began working with Lestrade, he failed far too much for his liking. In fact, just before he met John, he calculated at the rate he was going, he'd run out of skin before he died, and that was with his realistically low life expectancy taken into account.

But after John... Sherlock didn't know what it was about the man, but he made Sherlock better. The flow of names slowed, and Sherlock calculated that he would die without every inch of his skin covered in scarred names. There were still people he failed to save of course, because no matter how hard he tried, he couldn't be perfect, but John Watson made him better.

Soo Lin. The elderly woman. (He thought for a while about putting The Woman's name somewhere near his heart, but that was too sentimental. In the end he hadn't decided by the time she came back to life, only a week later.)

He thought about putting his own name there too, since he did fail to save himself. But then he'd also have to put John's name, since he failed to save John. Just not in the most obvious way. (Making him watch was cruel, so cruel, but he _had _to-)

It had crossed his mind to carve 'freak' or 'failure' in his skin instead, but that would just make him angry, all the time. Instead he carved the names of the people he didn't save in his skin instead, to inspire him. To motivate him. To make sure the next time he would be better.

(It hadn't worked yet.)


	2. Chapter 2

He didn't do it those two years away. He couldn't. He was running for his life much of the time, and there would be no self inflicting wounds that may not be able to be kept sanitary.

(He kept two names for when he returned. Just two. The rest he didn't regret at all.)

The Serbian man who tortured him noticed them, but only smirked, and didn't comment. Sherlock didn't even know if he spoke or read English, so perhaps he didn't understand what they meant, a continuous list of his failures for him to carry forever.

He only inflicted new ones in the places Sherlock couldn't reach on his own to etch.

Sherlock supposed he could thank him for that. For not covering up previous ones, that he'd only have to redo once (if) he made it home.

In the end, he made it home, all his previous names intact, with new scars that held no meaning.

* * *

He hoped that everything could go back to the way it was, but he knew, somewhere deep in his mind palace, a place that he wanted to deny even existed, that it could never happen.

And he was right, of course. Because John had mourned and moved on and fallen in love.

So Sherlock went back to Baker Street alone, and continued as he had before.

He nearly lost John right off the bat, and he couldn't have lived with that. He wouldn't have died with John's name scarred on his skin, he would have died with it freshly oozing. John Hamish Watson would have been the death of him, figuratively and quite literally.

But he saved John, and then he stopped the bomb, which was good. If the bomb went off, he'd run out of blood and skin sooner than he'd run out of the names of people he failed to save.

John got engaged to Mary, and Sherlock focused on planning the wedding rather than taking cases that he could fail at.

At John's insistence, he took a case, and was planning where to put Private Stephen Bainbridge's name when John announced he was still breathing.

A close call.

He went back to wedding planning. When the big day came, he'd nearly had to put Major James Sholto on there, but he saved him, mostly thanks to Mary.

So of course it was Mary who found them, who saw them and understood what they meant. She was far too clever for her own good.

(It was why John had fallen in love with her.)


	3. Chapter 3

"Are you sure John is fine with this?" he asked, for what would have been the fourth time, if he'd been counting, which he wasn't.

"With his wife taking his best friend out shopping? Quite. In fact, he insisted. He told me, 'Mary, if Sherlock pops a button on one of his shirts and pokes someone's eye out, I will not be bailing him out of jail on manslaughter charges. Take him shopping and get him more reasonable clothes.' To which I replied 'Why shouldn't you?' and then he told me about the single shopping trip the two of you went on which ended in Mycroft intervening before both of you could be thrown in a jail cell."

Sherlock pouted. "He exaggerates."

Mary only laughed.

It was by the third store that Sherlock suspected Mary had begun to understand why John refused to take him shopping. Mary had thrust countless button up shirts, jumpers, and jackets at him, and he'd refused all of them. Some of them he didn't try on, others he could barely wait to rip off his skin they felt so awful. Some of them just looked wrong.

Sherlock hoped if it kept up at this rate, Mary would give up soon and they could go home.

Until then, he sighed at the pile of clothing she brought him, and set about trying them on.

"How does the blue shirt look?" she called through the curtain.

Sherlock frowned at himself in the mirror. It looked fine, but it felt awful. Pulling at places it shouldn't have, itching in others.

"No," he told her.

"How can a shirt look _no_?" she asked.

"It just does," Sherlock snapped. "I'm not getting it."

He began undoing the buttons and flung the shirt on the hook, noting with disappointment that it actually stayed.

It was almost a pity. The colour was rather nice.

Apparently Mary thought so too. "Sherlock!" she huffed.

She pushed her way into the dressing room. "No, you have to let me _see-_" she insisted, stopping short once she saw Sherlock's bare upper arms.

He hugged himself defensively. "I told you not to come in," he mumbled, more to himself than to her.

"Sherlock," she said quietly. "What are those?"

He glared at her reproachfully. It was fairly obvious what they were. In the florescent lights, the scars were clearly evident on his skin. Mary may not have been able to make out what they said, but there was no denying what they were. Thankfully his back was to the wall so she couldn't see the ones inflicted while he was away. They were far more unnerving.

He ignored her question.

"Please don't tell John."

He wanted to pretend he wasn't begging, because that was beneath him, but they both knew he was.

"Sherlock, he would want to know," she whispered.

Sherlock shook his head. Maybe he'd _want _to know, but it wouldn't help anyone if he did. He'd only blame himself for not noticing, berate himself because he'd never seen it, ask himself what he could have done to stop it.

Everything that Sherlock had already done.

And he didn't want John to go through that.

But he would.

Because Mary was wonderful and kind and accommodating and intelligent, but she was also loyal. And her loyalty would require her to help Sherlock, even if it meant not giving him what he wanted, what he was begging her for.

"He needs to know," she insisted, her fingers light on his scars, and still more painful than the scalpel that inflicted them.

He flinched away from her.

"You are going to tell him either way, but you want my blessing to do it. You think that if I agree it will mean I want to recover," he said flatly. "But this isn't something to recover from. It just is."

Mary winced at his words. "Yes, I am going to tell him. And yes, I would like to have your permission to do so, but it's not so you can... recover. No one can make you recover from something that you use to _help_ you recover."

Sherlock blinked at her. She had come the closest that anyone had to understanding. Not quite, but close.

(Every day, he was reminded in a new way why John married her.)

He nodded once, sharply.

"Fine."

That was the end of the conversation.

(They ended up not buying anything. Sherlock wondered what she told John about the shopping other than the obvious.)


	4. Chapter 4

He received a text in the evening from Mary, inviting him back in the morning. He accepted, knowing it wasn't optional.

He wondered what it would be like, if it would be an intervention, the three of them (perhaps Lestrade and Mycroft as well? He certainly hoped not) sitting in armchairs, cups of tea as security blankets, clutched in their respective hands as they all searched for words that no one wanted to say.

* * *

It wasn't so far off. The three of them did end up in John and Mary's living room, cups of tea in their hands. John and Mary sat on the couch together, Sherlock across from them in an armchair.

Sherlock sipped at the tea. Mary had made it, he could tell, because it wasn't perfect. John knew how to make it perfect, unless he was angry, then he would (unintentionally? Intentionally?) mess it up.

He didn't make eye contact with either of them.

"Sherlock," John said. Sherlock looked up at him. "Mary told me," John said, his jaw tight, hand steady.

Sherlock nodded. "I know," he replied simply.

"I've been beating myself up all night," he admitted.

Sherlock nodded once more, looking back at his tea. "I know," he echoed.

"How many?" John asked quietly. Asked because he knew Sherlock would know the exact number, the date, the reason, the case. Because the man who deleted the solar system would never delete something as important as a human life.

"Seventy three."

Sherlock didn't look at him, didn't want to deduce, didn't want to know. (He didn't need to look.) He could sense the emotion coming off John in waves. Shame, guilt, disappointment, pain, anger, sadness...

Pointless, really. Sherlock was a grown man and could make decisions about his body if he wanted. If he'd chosen to get tattoos of the names instead, would John have grounds to complain? No. But as soon as one takes up a scalpel rather than a tattoo gun, something that is more accepted, then it's a _problem. _

And Sherlock knew he could rationalize it like that, call it a statement, cite the numerous countries that still used scarification as art forms, as rites of passage. He could do that.

(But Mary could always tell when he was fibbing.)

Because it wasn't any of those things. It was punishment and it was penance and it was a reminder each and every day that he had failed.

"I can't stop," he told them. _Won't stop._

John opened his mouth to speak, to protest, but Mary spoke first.

"I understand," she told Sherlock. "I really do. They're names, aren't they?"

Sherlock nodded mutely.

"Who are they?" Mary asked gently.

Sherlock wasn't sure if he could remember how to speak. Somehow the language wings of his mind palace had become locked down. No visitors allowed.

Instead of speaking, he pulled at the buttons with unsteady fingers, and revealed his left upper arm to John.

He didn't watch as John leaned in to make out the faint words that had once been etched into his skin in red.

"Soo Lin? Sherlock, that's the girl from the case with the bankers. She died."

Sherlock nodded, still not looking at John. He only hiked his right pants leg up in response to reveal the scar there.

"Gabriella Monroe? That's... she was the teenager who was raped and killed by that serial killer... Jakob something."

He could feel John staring at him. "You'd been on the case for a week, and you caught him right after that."

Sherlock nodded.

"Sherlock," Mary asked. "Do you blame yourself for those people dying?"

Sherlock bit his lip, but nodded once more, minutely. He was still searching for the keys to the language wing, but so far had not had any luck.

He knew it didn't make sense and he knew it wasn't his fault, but if only he'd been better, faster, smarter, none of them would have had to die. (People liked having someone to blame, and he was no exception. He just used himself.)

Mary shifted herself from the couch to crouching on the arm of the chair Sherlock was sitting in.

"Oh Sherlock, it's not your fault. People die. That's just a part of life. Sometimes it's in awful, preventable ways at the hands of others, but it is most definitely not your fault. You have saved so many of them. Have you ever thought about that?"

"Of course," he muttered.

She cupped his face in her hands. "And you never thought of keeping track of the ones you saved, did you?"

Sherlock frowned, avoiding her gaze. Of course not. He kept track. He'd call in favours all the time, like with Angelo and Mrs Hudson. Of course he knew the number of people he saved.

Right?

But searching for the number, he couldn't find it. There were too many variables. How many people _could _have died if the bomb went off? How many people _could _have died if a serial killer went on murdering? How many people _could _have died if he hadn't interfered in so many lives like some god weaving an immense tapestry of intertwining threads?

That was the problem. Deaths were tangible, bodies could be counted, names could be taken down and noted. The possibility of survival branching out from a fixed point could never be entirely accounted for.

Mary must have seen the doubt in his face.

"You have saved so many, and there are so many more that you can never know that you've saved."

"You saved me," John offered quietly.

"And how many people has John saved since them?" Mary asked him. "Hmm? How many lives has he touched since then? Because you are responsible for saving all of them, no matter how indirectly." Mary's finger tipped his chin up, forcing him to look at her. He glanced at her face for a split second, and she smiled. "There you go."

Sherlock couldn't help himself. He smiled slightly.

Mary shifted to the floor in front of him.

"Sherlock," she said firmly. "Unless you held a gun to someone's head and pulled the trigger, unless you were the one carving out arteries and watching them bleed, unless you were the one strangling and suffocating them until all the life left them, _you are not responsible for their deaths. _You have to understand that. You're clever; I know you can do it."

Sherlock glanced between the two of them. Mary was wearing an expression of something close to (remembrance? which couldn't be quite right...) understanding, and John was staring at his wife with a hint of pride, and some astonishment, like he didn't know she had it in her.

Sherlock finally managed to unlock the language wing.

"You're not telling me anything I haven't told myself hundreds of times before," he said flatly.

"Oh Sherlock," Mary sighed, wrapping him up in her arms, despite his wincing. "Sometimes you just need to hear it from a different perspective before you can start to believe it."

"I don't know if I can stop," he admitted, glancing at John. _He'd let him down._

John only nodded. "I understand. But... Sherlock, you don't have to do it alone. Any of it. Cases, the stuff afterwards, whatever," he said, gesturing to Sherlock's body. "We're both here for you. And Lestrade would be too. But we're not going to tell him," he added hastily, noting Sherlock's panicking expression.

Sherlock sighed, and resigned himself to accepting that John and Mary weren't going to give up on the topic.

Sentiment.

He accepted another cup of tea before heading home.


	5. Chapter 5

It was only a few weeks later when there was another case with an unfortunate ending. Drugs laced with toxins had been distributed throughout the city. Sherlock went undercover to catch the drug dealer responsible, but not in time to prevent one final death. By the time Sherlock and John tracked the final client down, he'd already died.

Sherlock could feel the way John looked at him at the crime scene, and in the taxi home. (Because yes, of course John was going to accompany him home after that.)

"Do you think you're going to talk me out of it?" Sherlock asked him quietly as soon as he finished paying the driver.

John shook his head as Sherlock unlocked the door. "No one can talk out of doing anything. But I'm going to be here for you."

Sherlock frowned, but dismissed it as yet another expression of sentiment he didn't understand.

John followed him into the bathroom after he tossed his coat on the couch, taking care to pull out the pad of paper with the young man's name on it.

Sherlock stuck the sheet to the mirror with a bit of tape and moved on.

He ignored John best he could, pulling out the supplies, noticing with distraction that John was rolling up his pant leg for some unknown reason. He said something that Sherlock didn't hear.

"What?" he asked, glancing up at John, leg bare.

"Do it on me," John repeated, kicking his leg impatiently.

Sherlock still couldn't wrap his head around it. "What?"

"Do it on me. Instead of you. I'll bear this one. It's my fault anyway."

Sherlock swallowed against the roiling in his stomach. "It's not your fault John," he said quietly.

"It is though," John insisted, looking at least somewhat miserable. "I want to. You can do it, or give me the scalpel and I'll do it. You're running out of room, and I can bear some of the load."

Sherlock shook his head. "I can't."

"Why not?"

Sherlock shook his head again. He didn't even know. How could he explain it to John? "I don't want you to hurt." _I'd do anything to prevent that. I did, do you remember that? I did it to you for two whole years, just to keep you from the worst hurt of all, and I'm sorry, but I can't do that again._

John looked at him kindly. "Sherlock, mate, I don't want to see you hurt. Do you understand?"

Of course he understood. John was just saying words and he was hearing them and they were being comprehended in his brain and he was thinking about them and mulling over them and of course he understood.

But on one level, he really didn't.

"Sentiment?" he hazarded.

John grinned at him. "Quite right."

"I'm not going to do it to you," he affirmed. "And I won't let you do it."

John shook his head. "You can't stop me. Whatever you cut into your skin, I'll do as well."

Sherlock glared at him. "That's not fair."

"The world isn't fair," John replied sadly. "And if you think commemorating all those people who died by carving their names into your skin is going to make it somehow fairer, then I think you've lost your touch."

Sherlock considered that.

Of course it wasn't going to restore balance to the universe. (Throwing the man out of the window who hurt Mrs Hudson would. Action and reaction.) He knew that.

_So why do you keep on doing it? _he whispered to himself.

Sherlock tilted his head. "I don't know how to not do this," he admitted.

John smiled. "That's alright. I do." He closed the case that contained the scalpel. "Now, I don't suppose you saw the things I left in the freezer?"

Sherlock frowned. "What things?"

"Excellent."

Sherlock trailed John to the kitchen as he began pulling out body parts. _How on earth did he miss those?_

"I suspect you didn't do a lot of eating this week, and sure as hell not a lot of cooking, so I'm not surprised you didn't see them."

Sherlock frowned at what John was implying, but had no time to focus on that. Not when John had brought him body parts.

"Where were you going to do it?" John asked.

Sherlock looked up sharply.

"Where were you going to put his name?" John said, more gently.

"Oh. Right thigh."

John nodded, and went back to pulling out and repacking various frozen pieces of meat until he found what he was looking for.

He set a piece of meat that looked suspiciously like a human thigh on the table. (He could figure out what it was if he was given a little bit of time, and his microscope-)

"We're not doing experiments on it," John told him firmly, perhaps noting the glint in Sherlock's eye. "You're going to use it instead of yourself."

"What?"

"Carve the name into the meat instead of yourself. It may take a bit of work, it's sort of frozen."

Sherlock snorted. Of course it was frozen.

Still, he took the scalpel John handed him, not _his _scalpel, and examined the leg of some unfortunate creature.

He closed his eyes and remembered the name on the mirror.

Jonathan Basser. 23. No father in the picture. Mother works two jobs to support her son, who she was trying to put through college. Digital design. Hadn't used drugs much before. Not a regular user. Smoker.

Sherlock carved all of these things into the leg on the counter.

When he finally looked up, John was staring at him.

"What was the cause of death Sherlock?"

"It's hard to say at this point-"

"Don't," John interrupted. "You're sure enough."

Sherlock sighed. "Likely respiratory depression as a result of the fentanyl laced heroin."

"Did you laced the heroin with fentanyl?"

"No-"

"Did you inject the heroin into Jonathan's arm?"

"No-"

"Then you did not kill him," John said firmly. "Jonathan is a grown man. He took the risk of using drugs, and he unfortunately lost his life. But that is not your fault. Now carve it into the leg."

Sherlock was quite sure that phrase had never been uttered before, but he obeyed nonetheless.

CAUSE OF DEATH: NOT SHERLOCK HOLMES

He stepped back to admire his handiwork.

"Do you feel okay? Good?"

Sherlock considered that.

"Yes," he said, a bit surprised about his response. Yes he did.


End file.
